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@csrf

Payment Summary

Urgent Care Consultation ${{ config('services.pricing.urgent_care', '39.00') }}
Total ${{ config('services.pricing.urgent_care', '39.00') }}

Payment Information

@error('card_holder_name')

{{ $message }}

@enderror
@error('card_number')

{{ $message }}

@enderror
@error('expiration_month')

{{ $message }}

@enderror
@error('expiration_year')

{{ $message }}

@enderror
@error('cvv')

{{ $message }}

@enderror
@error('billing_address')

{{ $message }}

@enderror
@error('city')

{{ $message }}

@enderror
@error('state')

{{ $message }}

@enderror
@error('zip')

{{ $message }}

@enderror
@error('agree_terms')

{{ $message }}

@enderror

Secure Payment

Your payment information is encrypted and secure. We do not store your full credit card details.